The problem is, you can't fight healthcare changes one issue at a time. The AMA and other stake holders have to come to the table in a proactive stance and propose something that reduces the cost, not just the insurance payments, but the actual cost of applying healthcare while keeping doctors, hospitals, insurance companies and patients from being gored at the same time.

Everyone who negotiates contracts knows you can't finalize a negotiation when it’s conducted issue by issue. Someone has to step up and put everything in healthcare on the table and be ready to make some compromises that reduce the ever-increasing cost of providing healthcare.

We live with a system that for 50 years has had one mantra: "To make more, you do more." Now we have to learn to live with less doing and still make it possible for hospitals and physicians to prosper. We’re adding approximately 12,000 people a day to the Medicare rolls and this will continue for the next 18 years. If you think there won’t be cuts, you're dreaming! Cuts are necessary if the system is to survive. The 12,000-a-day added to Medicare is above and beyond the 30 million added with the Patient Protection and Affordable Care Act (PPACA), i.e., Obama Care. Something has to give.

Now the question is, are we capable of coming to the table and looking at Medicare/Medicaid, the Veterans Administration Hospitals and healthcare for the general population and finding a better path to provide quality healthcare at a lower cost of administration? Not a lower cost of insurance, but a lower per-patient cost. It’s possible, and we must do it if our healthcare system is to continue to prosper.

I think it’s better to set healthcare standards, dissolve all the bureaucracies and let independent insurance companies bid for the business. Give Medicare/Medicaid recipients and veterans an insurance policy and let them seek the best care. Hospitals and doctors will compete for their business. Supplying healthcare is going to be costly in any case, but do we really need all the middle men in the government? I think not.